Monovision
Posted , 3 users are following.
So before jumping to surgery I am trying to simulate monovision with contacts. Optometrist had me try a -900 in my Right dominate eye and -700 in left eye. I can read my phone and other items much better than when I used multifocal contacts. The distance vision was Ok but not great. I can drive but I cannot really make out street signs well. I went back and to give me better distance he kept my right eye at -900 but gave me a -800 for my left. I asked why not increase just the right and he said it would not work it will be too "powerful" and throw me off. I have not tried them yet but would appreciate any thoughts or suggestions.
thank you
0 likes, 7 replies
RonAKA Songirl
Edited
First, it is a great idea to test drive monovision before jumping in if you can still see well enough to evaluate it. Since you are highly myopic there is a conversion in power required from an eyeglass prescription to a contact lens prescription. Since the contact lens sits closer to your eye, less power is needed when you are in the high myopic range. As a starting point you need a current eyeglass prescription that is working well for you. A cataract can change your power needed over a relatively short period of time, so you need a current prescription for eyeglasses. I looked back and you posted about 7 months ago that your eyeglass prescription was:
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Right Eye: -11.75
Left Eye: -11.00
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There is a conversion calculator on line from CooperVision that you can use to convert this to a contact lens prescription. If you google this text below you should be able to find it. When you get to the page click on OptiExpert. That is the tool that does the conversion.
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"coopervision spectacle to contact lens calculator"
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With the eyeglass prescription above this is what I got from the calculator as the required contact lens power.
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Right Eye: -10.3 D (a -10.00 or -10.50 should work, or a -10.25 if available)
Left Eye: -9.72 D (a -9.50 or -9.75 if available should work)
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The next step to simulate monovision is to reduce the left non dominant eye by 1.5 D. This would bring you down to a -8.00 D ( or -8.25 if available) lens. The -7.0 lens he gave you is too low, but the -8.0 D lens should be about right. But for your right eye, if these eyeglass prescriptions are right you need -10.0 or -10.5 D. This will give you much better distance vision as the -9.00 he gave you is leaving you about 1.30 D myopic.
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I would go back and ask for a lens that gives you full distance correction in the right eye. There is no reason to under correct the distance eye for monovision.
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The other thing to consider is astigmatism. If you have astigmatism you may want to get toric contacts. The calculator can handle the cylinder (astigmatism) as well. You do not want to reduce the cylinder for the left eye though. Just the sphere needs to be reduced by 1.50 D.
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Hope that helps some. If you have a more current eyeglass prescription, I could do the conversion again. But, that OptiExpert tool is very easy to use.
Songirl RonAKA
Posted
thank you so much for coming through for me once again. I am so happy to hear what I was thinking is what you stated. I even told him when I close my left eye the distance was not good. I hope I can convince him to let me try higher for the right and not dismiss me. I did ask about astigmatism and he said not much. I also stated so I dont need a toric and he said no.
This is such a frustrating process dealing with people who are so unknowledgable. Thank goodness for you and this forum.
RonAKA Songirl
Edited
If there is not much astigmatism (less than -0.5 D cylinder), it is not likely worth it to correct with a toric contact. I find toric lenses less comfortable than a plane non toric.
Songirl RonAKA
Posted
As I mentioned before with the -7.00 in my left eye, I can see my phone pretty well. If I do the -8.00 or -8.25 will the near vision get worse?
RonAKA Songirl
Posted
Yes, you are going to lose some of your very close vision if you reduce your astigmatism more. Monovision in the close eye is a bit of a compromise. The more myopia that you leave the better your close vision, but the poorer the distance vision in that eye. And if you leave too much myopia you can leave a hole in your vision at the intermediate distance between what the distance eye covers and what the near eye covers. Every study I have seen has concluded that leaving the close eye at -1.25 to -1.5 D is very close to ideal. My own personal experience validates that.
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One thing I find I have to keep reminding myself about is that with higher myopia and no glasses the closer you hold something the better you see. However with an IOL set at -1.5 D, vision for me starts to get fuzzy at about 12". I have to resist holding something closer and move it back out to 12".
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Keep in mind that contacts are cheap and most manufacturers supply free samples to optometrists and optical supply companies. Ask for a range of contacts to try in each eye. I think about -8.0 in your left eye, combined with -10.0 D in the right should work well if that prescription is current.
Songirl RonAKA
Posted
My next appt. for f/u with the optometrist is 7/9. I do have an old -10.00 multi focal lens that I was thinking of trying in my r eye and the -8.00 he gave me for l eye until I can get to see him. Do you think its worth trying or not because it is a multi focal? I am concerned about loosing my very good super close vision. When wearing either glasses or contacts and I want to zoom in I do get frustrated and either remove my glasses or contacts to see. You say you have to remind yourself, is this something you get used to over time? I kind of swore off the idea of panoptix because of all the negatives I am reading, however it sounds like that lens allows to keep the super close vision. Ahh the joys of getting older. lol
RonAKA Songirl
Edited
I think using the -8.00 and your -10.00 Multifocal contact is worth a try. It is not going to simulate mini-monovision perfectly due to the MF effect of the right eye. But, it should let you know if this solves the distance vision problem. That will give you more ammunition to convince your optometrist to give you the -10.00 lens to try. If you are a Costco member, they are pretty liberal in giving out free lenses to try as long as you have a prescription to show them. I tried about 6 different kinds of contacts and like the Costco Kirkland daily ones the best. They are made by CooperVision.
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The reality is that with all IOL's you are not going to get the super-vision close that you have now with your glasses off. The only way to do that is to ask for an IOL that leaves you at -9.00 or so. The other option is to be left at -3.00, but I would not suggest that either. I would try the -8.00 contact and the -10.00 to see how that works for you. And remember to hold things 12" or a bit further away for best vision close. What I do when I need really close vision is to grab a pair of my +1.25 OTC readers. That is perhaps once a week or so. The rest of the time it is just my IOL's and no glasses.